Discoveries & Impact highlights publications per section across the Department of Internal Medicine.
Cardiac allograft vasculopathy is a leading cause of death among heart transplant recipients. In this review Albert Sinusas, MD, and Attila Feher, MD, PhD, discuss the value of PET in the evaluation of cardiac allograft vasculopathy.
Feher A, Sinusas AJ. Evaluation of cardiac allograft vasculopathy by positron emission tomography. J Nucl Cardiol. 2021 Jan 3. doi: 10.1007/s12350-020-02438-0. Epub ahead of print. PMID: 33389637.
A multi-center observational study of 1,601 patients evaluated the long-term impact of hepatitis C virus (HCV) therapy with direct-acting oral antiviral drugs. A study published last month in Liver International reports on patient-reported outcomes (PROs) from pre-treatment to 12 months post-treatment. “On average, small improvements were observed at 3 months post‐treatment in all PROs and sustained at 12 months post‐treatment among patients with sustained virologic response (SVR),” the authors wrote. Clinically meaningful improvements were achieved in fatigue, sleep, abdominal pain, and functional well-being. The patients with cirrhosis had the greatest improvements in functional well-being, according to the authors.
Serper, M., Evon, D.M., Amador, J., Stewart, P.W., Sarkar, S., Lok, A.S., Sterling, R.K., Reeve, B.B., Golin, C.E., Reddy, K.R., Lim, J.K., Reau, N., Nelson, D.R., Di Bisceglie, A.M. and Fried, M.W. (2021),. Liver International. https://doi.org/10.1111/liv.14781
Endocrinology & Metabolism
In an abstract published this year, a team of investigators reports that a specific signaling pathway is activated by metabolic stress, promoting the development of metabolic syndrome, including hyperglycemia, hyperlipidemia, and insulin resistance. “This integrated physiological response involves cross-talk between different organs. Here we demonstrate that cJun NH2-terminal kinase (JNK) signaling in adipocytes causes an increased circulating concentration of the hepatokine fibroblast growth factor 21 (FGF21) that regulates systemic metabolism,” the researchers wrote. Learn more in .
Han MS, Perry RJ, Camporez JP, Scherer PE, Shulman GI, Gao G, Davis RJ.. Genes Dev. 2021 Jan 1;35(1-2):133-146. doi: 10.1101/gad.344556.120. PMID: 33334822.
General Internal Medicine
Applying a social ecological model (SEM) to describe the potential and observed range of effects of the COVID-19 pandemic on individuals with opioid use disorder (OUD) is discussed in a commentary published in January in Addiction Science & Clinical Practice. The pandemic “has posed unique and poorly characterized challenges” for individuals with OUD, the authors explained. Theoretical modes “can guide scientific inquiry, interventions, and public policy. Models also provide a visual image of the interplay of individual-, network-, community-, structural-, and pandemic-level factors that can lead to increased risks of infection and associated morbidity and mortality for individuals and populations.”
Cowan E, Khan MR, Shastry S, Edelman EJ. . Addict Sci Clin Pract. 2021 Jan 7;16(1):4. doi: 10.1186/s13722-020-00210-w. PMID: 33413619; PMCID: PMC7789072.
Researchers developed a 180-day readmission risk model for older adults with acute myocardial infarction (AMI) that included a broad range of characteristics, including functional mobility and self-reported health status, neither of which have been previously considered in 180-day risk models, they said inlast month. The researchers concluded that over 40% of participants were readmitted within 180 days. They used data from the ComprehenSIVe Evaluation of Risk in Older Adults with AMI (SILVER-AMI), a prospective cohort study that enrolled patients 75 years of age or older, with data from 94 hospitals in the U.S.
Dodson JA, Hajduk AM, Murphy TE, Geda M, Krumholz HM, Tsang S, Nanna MG, Tinetti ME, Ouellet G, Sybrant D, Gill TM, Chaudhry SI.. Open Heart. 2021 Jan;8(1):e001442. doi: 10.1136/openhrt-2020-001442. PMID: 33452007; PMCID: PMC7813425.
In a, a team from Yale created institutional guidelines for repeat plerixafor dosing in stem cell mobilization for use in patients with multiple myeloma and lymphoma. The authors hope the algorithms will improve patient experience, along with improving resource utilization.
Gupta GK, Perreault S, Seropian SE, Tormey CA, Hendrickson JE.. Transfus Apher Sci. 2021 Jan 27:103069. doi: 10.1016/j.transci.2021.103069. PMID: 33546988.
Yale researchers looked at immune response and chronic inflammation of persons with and without HIV infection with an opioid use disorder who use methadone or buprenorphine. In this prospective, longitudinal study of 135 participants, this paper shares the recruitment, laboratory, and statistical methods of the study, in addition to protocol in hopes to determine whether methadone or buprenorphine is best for individuals with HIV and opioid use disorder.
Biondi BE, Mohanty S, Wyk BV, Montgomery RR, Shaw AC, Springer SA.. Contemp Clin Trials Commun. 2021 Jan 6;21:100704. doi: 10.1016/j.conctc.2021.100704. PMID: 33490708; PMCID: PMC7807244.
Burtness, B, Contessa, J.JNCI.
In this study, Yale researchers looked at the association of COVID-19 infection with acute kidney injury (AKI). They looked at 22,122 patients hospitalized from March to August of 2020, and found that patients with COVID-19 had more AKI, more severe AKI, and a lower recovery from the condition than other hospitalized patients. Future research is necessary to look at how COVID-19 may cause AKI. Learn more in the.
Moledina DG, Simonov M, Yamamoto Y, Alausa J, Arora T, Biswas A, Cantley LG, Ghazi L, Greenberg JH, Hinchcliff M, Huang C, Mansour SG, Martin M, Peixoto A, Schulz W, Subair L, Testani JM, Ugwuowo U, Young P, Wilson FP.. Am J Kidney Dis. 2021 Jan 7:S0272-6386(21)00003-2. doi: 10.1053/j.ajkd.2020.12.007. PMID: 33422598; PMCID: PMC7791318.
Pulmonary, Critical Care & Sleep Medicine
In a study that aimed to uncover potentially new disease mechanisms that can be easily treated, researchers discovered that macrophage-derived NTN1 drives the development of fibrosis through a mechanism involving remodeled adrenergic nerves, their secretory product noradrenaline, and α1 adrenoreceptors. Further, the researchers recently stated in“this axis is at least partially intact in humans with Idiopathic pulmonary fibrosis (IPF) where it may be targeted with safe and well-tolerated α1 adrenoreceptor antagonists that are already FDA approved.”
Gao R, Peng X, Perry C, Sun H, Ntokou A, Ryu C, Gomez JL, Reeves BC, Walia A, Kaminski N, Neumark N, Ishikawa G, Black KE, Hariri LP, Moore MW, Gulati M, Homer RJ, Greif DM, Eltzschig HK, Herzog EL.. J Clin Invest. 2021 Jan 4;131(1):e136542. doi: 10.1172/JCI136542. PMID: 33393489; PMCID: PMC7773383.
Rheumatology, Allergy & Immunology
Dual-energy X-ray absorptiometry (DXA) is used to measure bone mineral density (BMD) in the diagnosis of osteoporosis, but technical aspects of DXA measurement, including selection of different scanning modes, may impact readings. Using the European Spine Phantom (ESP) to perform ex vivo measurements across 19 hospitals with Hologic DXA machines in China, significant differences were observed between average ESP BMD for the Array and Express Array scan modes, and between Fast Array and Express Array scan modes. However, no significant difference in average ESP BMD was observed between the Array and Fast Array scan modes. In the appropriate context, the Fast Array scanning mode may be a reasonable choice for Hologic DXA machines, said the researchers. Future in vivo studies can help guide the clinical application of these findings. Learn more in the.
Yu W, Zhang Z, Pan W, Guan W, Lin Q, Xia W, Li T, Hsieh E.J Clin Densitom. 2021 Jan 9:S1094-6950(21)00003-2. doi: 10.1016/j.jocd.2021.01.003. PMID: 33504451.